Medical Technology

At-Risk Americans are Eligible for the 4th COVID Shot This Week

Editor’s note: Find the most recent COVID-19 news and guidance in Medscape’s Coronavirus Resource Center. Coronavirus Resource Center.

A fourth dose of coronavirus vaccine is now available for Americans who have an insufficient immune system and are at a high risk of developing severe COVID-19.

The CDC recommended a third dose of the Pfizer or Moderna vaccines for severely and moderately immunocompromised people on Aug. 13th. It is considered part of the first vaccination series instead of an additional shot.

In October, the CDC said moderately and severely immunocompromised patients could get a booster shot or a fourth dose vaccine, 6 months after their third dose.

The CDC reduced the duration to five months last week to sign up for the booster shot of Moderna or Pfizer vaccines. The immunocompromised population could begin signing up for a fourth shot in the coming weeks, The New York Times reported.

According to CDC the CDC estimates that around 2.7 percent of U.S. adults are considered immunocompromised. This is roughly 7 million adults. They are more likely to contract severe COVID-19, have an increased risk of long COVID and have lower levels of antibodies after vaccination, and may develop serious breakthrough infections. About 40 percent of hospitalized breakthrough cases are in immunocompromised patients.

According to CDC guidance the CDC guidelines, individuals are considered to be “moderately or severely immunocompromised” If they suffer from:

  • Active treatment for cancerous tumors or blood cancers

  • Have received an organ transplant and are now taking medications to suppress the immune system.

  • In the last two years, we have received an embryonic stem cell transplant and currently taking medication to suppress the immune system

  • Advanced or untreated HIV infection

  • Primary or severe immunodeficiency, such as DiGeorge syndrome or Wiskott-Aldrich syndrome.

  • Active treatment using corticosteroids in high doses and other medications that suppress the immune system.

Only moderately or severely immunocompromised Americans are eligible for the fourth shot. Israel has begun offering fourth doses to high-risk groups including older adults, but the Biden administration hasn’t yet said whether the U.S. will follow, the Times reported.

Overall, the focus is on getting third shots to Americans who are eligible for boosters, Rochelle Walensky, MD director of director of the CDC director told reporters on Friday. The American government will continue to interact with Israel in order to track their data on fourth shots.

“We will be monitoring our own data with care as well, to find out how these boosters work in terms of their effectiveness waning not just for infection, but also for severe diseases,” she said.


The New York Times: “Starting later this week some at-risk Americans will be eligible for a fourth shot.”

CDC: “ACIP Evidence to Recommendations to Use an Additional COVID-19 Vaccine Dose in Immunocompromised People.”

CDC: “COVID-19 Vaccines For moderately and severely immunocompromised persons.”

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